[b]^ O -bservable signs and symptoms[/b] [b]HERE'S A SAMPLE DISCHARGE PLAN USING METHODS :[/b] [b] I made this one...You may use this a guide \m/[/b] [b]Medications[/b] [b] > Advised patient to take medicine religiously as prescribed by the physician[/b] 1. Cefuroxime (Panaxim) 750g IVTT every 8 hours Classification ( C ): second generation cephalosporin Indications ( I ): Bone & joint infections, osteomyelitis, septic arthritis, skin & soft tissue infections, lower respiratory tract infections, pharyngitis, sinusitis, gonorrhea, meningitis, otitis media, peritonitis, UTI, prophylaxis in surgery. Action ( A ): second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal. Contraindications ( C/I ): Hypersensitivity to cephalosporins. Adverse Reactions ( A/R ): GI disturbances, pseudomembranous colitis, dizziness, headache, hypersensitivity reactions, local injection site reactions. Nursing considerations 1. Instruct patient to take the drugs as prescribed. 2. Instruct patient to take drug with food or milk to lessen GI discomfort. 3. Tell patient to notify prescriber if rash or signs and symptoms of superinfection develop. 2. Cefuroxime (Zegen) 500g 1 tab every 12hours PO C: Cephalosporins I: Treatment of bone & joint infections, bronchitis (& other lower resp tract infections), gonorrhea, meningitis, otitis media, peritonitis, pharyngitis, sinusitis, skin infections, surgical infections & UTI. A: a semisynthetic, broad-spectrum 2nd generation cephalosporin antibiotic, exerts its bactericidal activity by interfering with the synthesis of the bacterial cell wall. It binds to penicillin-binding protein 3, responsible for the synthesis of peptidoglycan, a heteropolymeric structure that gives the cell wall its mechanical stability. C/I: Known allergy to cephalosporins. A/R: Thrombophlebitis. Pruritus, urticaria, positive Coombs' test, diarrhea, nausea, pseudomembranous colitis. Decrease in Hb & hematocrit, transient increase in liver enzymes, elevation in serum creatinine & BUN. Possibly seizure & angioedema. Nurrsing Consideration 1. instruct patient to take medications as prescribed 2. Inspect parenteral drug products visually for particulate matter and discoloration before administration whenever solution and container permit. 3 .Before cefuroxime therapy is instituted, careful inquiry should be made concerning previous hypersensitivity reactions to cephalosporins and penicillins. 3. Paracetamol (biogesic) 500mg 1 tab PRN C: Paraminophenol derivative I: Relief of fever, minor aches and pains. A: Thought to produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS or of other substances that sensitize pain receptors to stimulation. The drug may relieve fever through action in the hypothalamic heat-regulating center. C/I: hypersensitivity to drug, patients with long term alcohol use A/R: hemolytic anemia, leucopenia, neutropenia, pancytopenia, hypoglycemia Nursing Consideration 1. Tell parents to consult prescriber before giving drug to children younger than age 2. 2. Tell patient not to use fro marked fever (39.5 C), fever persisting longer than 3 days, or recurrent fever unless directed by prescriber. 3. Advise parents that drug is only for short-term use only. Urge to consult to prescriber if giving to children for longer than 5 days or adults for longer than 10 days. 4. Amoxicillin C: Penicillin I: Mouth infections, spleen disorders, gastroenteritis, lyme disease, susceptible infections, bronchitis, otitis media, UTI, biliary tract infection endocarditis, dental abscesses, typhoid fever, pneumonia A: inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs), thus inhibiting cell wall biosynthesis resulting in bacterial lysis. C/I: Hypersensitivity. A/R: Hyperactivity, agitation, insomnia, dizziness; maculopapular rash, exfoliative dermatitis, urticaria, hypersensitivity vasculitis; diarrhoea, nausea, vomiting; anaemia, thrombocytopenia, leucopenia, agranulocytosis. Nursing Consideration: 1. Obtain specimen for culture and sensitivity tests before giving first dose. 2. Before giving, ask patient about allergic reactions to penicillin. 3. If large doses are given or if therapy is prolonged, bacterial or fungal superinfection may occur, especially in the elderly, debilitated or immunosuppressed. 5. Multivitamins + Fe ( Hemarate) 1 cap BID PO PC C: vitamins and minerals (prenatal and postnatal) / antianemics I: Nutritional & Fe-deficiency anemia due to pregnancy, lactation & menstrual blood loss. Prevention & treatment of conditions associated w/ B-complex deficiency. A: vitamin that acts in a way to help prevent iron deficiency from blood loss C/I: hypersensitivity A/R: dizziness, weakness(rarely), nausea, Nursing Considerations: 1. Should be given to patient on an empty stomach (Best taken between meals. May be taken w/ meals to reduce GI discomfort.). 2. Instruct patient to take the drugs as prescribed. 3. instruct patient to swallow drug without breaking, crushing, or chewing them [b]Environment[/b] > Encouraged to maintain a clean and quiet environment > Advised to have a hazard-free surrounding > Encouraged to listen to soft music to facilitate relaxation > Encouraged to maintain a safe home free from any health hazards such as nails. > Encouraged to provide adequate lighting on stairs and in bathrooms to prevent injuries. > Encouraged to maintain cleanliness of the house and its’ surroundings. > Encouraged to provide curtains in bedroom to minimize external light and noises. [b]Treatment[/b] [b]> Encouraged to have a follow up check-up after discharge. Health Teachings[/b] > Encouraged to maintain an ideal body weight > Encouraged to avoid heavy works and stress > Advised to avoid smoking and drinking alcoholic beverages > Encouraged to increase oral fluids > Encouraged to exercise and ambulate often > Instructed to use soft bristle toothbrushes and to use gentle pressure when brushing > Encouraged to practice proper perineal care > Encouraged to have good hygiene by taking a bath always > Encouraged to have adequate rest and sleep > Encouraged diversional activities such as watching TV, reading newspaper or magazine > Instructed to do handwashing frequently > Encouraged a high-protein, low-salt, low-sugar diet rich in vitamin C > Encouraged to eat food rich in iron [b]Observable s/s[/b] [b]> Instructed to seek consult if the following s/s are observed:[/b] • Pale skin color • fatigue • irritability • dizziness • weakness • shortness of breath • sore tongue • brittle nails • headache - frontal • seeing bright colors • Missed menstrual cycle • Heavy menstrual period • dysuria (painful voiding of urine) • abdominal pain (radiating to the back on the affected side) • tenderness of the bladder area and the side of the involved kidney ("renal angle tenderness") [b]Diet[/b] > Instructed to avoid eating foods low in iron content > Instructed to eat meat, (especially red meat) which is high in iron > Encouraged to consume food sources rich in vitamin C such as oranges, dalandan, calamansi juice and fruits and vegetables in general > Encouraged to take iron supplements daily > Encouraged to increase fluid intake > Encouraged to consume cranberry juice, blueberry juice, and fermented milk products containing probiotic bacteria which have been shown to inhibit adherence of bacteria to the epithelial cells of the urinary tract [b]Spirituality[/b] > Encouraged to continue praying to God and to attend mass every Sunday > Encouraged to never lose hope and face each day with a smile > Encouraged to have a loving and harmonious relationship with the family [b]HOPE THIS HELPS....KEEP ROCKIN' ^^ \m/[/b]

Last edited by Angeli_7 (2008-08-04 11:47:17)